<%@ page language="java" contentType="text/html; charset=utf-8"
	pageEncoding="utf-8"%>
<%@ include file="/commons/taglibs.jsp"%>
<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="renderer" content="webkit">
<meta http-equiv="Cache-Control" content="no-siteapp" />
<title>会员信息服务</title>
<%@ include file="/commons/static.jsp"%>
<link rel="shortcut icon" href="${ctx }/home/common/img/favicon.png"
	type="image/x-icon">
</head>
<style>
.widget section {
	display: none;
}

i {
	color: #00a2ca;
}

i {
	padding-right: 5px;
	white-space: nowrap;
}

.radio{margin-top:0px!important}
h4{padding-top:10px}
</style>
<body>
	<div class="col-lg-8  col-md-12 col-sm-12 col-xs-12 col-lg-offset-2">
		<div class="widget">
			<div class="widget-header">
				<h2 class="text-center">常规问卷</h2>
			</div>
			<div class="widget-body" style="overflow: hidden">
				<div class="col-lg-12 col-sm-12 col-xs-12 ">
					<div class="widget">
						<section id="sec1" name="section1" style="display: block">
							<form class="form-horizontal form-bordered" id="form" role="form"
								action="${ctx }/customer/saveSurveyRepor" method="post">
								<input id="customerId" value="${id }" hidden name="customerId" />
								<input id="id" value="${re.id }" hidden name="id" /> <input
									id="content" hidden name="contentTional" />
								<div class="bancgud row">
									<div class="formfont wjdc_top col-lg-12">
										<img src="${ctx}/dep/img/wenjuan.png"> <span class="No">NO.1</span>
										<span class="inform">个人现病史信息</span>
									</div>
									<div>
										<h4 class="block col-lg-12">1.您目前或曾经是否被医生诊断过患有下列疾病（若有，请在“□”处选择，否则不用填写）</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="1"
													id="group_1_illness1_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">1型糖尿病</span></label> <label class="col-lg-3">
													<input value="2" id="group_1_illness2_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">2型糖尿病</span>
												</label> <label class="col-lg-3"> <input value="3"
													id="group_1_illness3_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">高血压</span></label> <label class="col-lg-3"> <input
													value="4" id="group_1_illness4_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">血脂异常</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="5"
													id="group_1_illness5_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">骨折</span></label> <label class="col-lg-3"> <input
													value="6" id="group_1_illness6_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">痛风/高尿酸血症</span></label> <label class="col-lg-3">
													<input value="7" id="group_1_illness7_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">哮喘</span>
												</label> <label class="col-lg-3"> <input value="8"
													id="group_1_illness8_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">冠心病/心肌梗死</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="9"
													id="group_1_illness9_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">类风湿性关节炎</span></label> <label class="col-lg-3">
													<input value="10" id="group_1_illness10_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">脑卒中/脑中风</span>
												</label> <label class="col-lg-3"> <input value="11"
													id="group_1_illness11_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">脑出血</span></label> <label class="col-lg-3"> <input
													value="12" id="group_1_illness12_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">代谢综合症</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="13"
													id="group_1_illness13_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢性腹泻</span></label> <label class="col-lg-3"> <input
													value="14" id="group_1_illness14_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">慢性便秘</span></label> <label class="col-lg-3">
													<input value="15" id="group_1_illness15_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">胃/十二指肠溃疡病</span>
												</label> <label class="col-lg-3"> <input value="16"
													id="group_1_illness16_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">骨质疏松症</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="17"
													id="group_1_illness17_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">已肝</span></label> <label class="col-lg-3"> <input
													value="18" id="group_1_illness18_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">胃、肠息肉</span></label> <label class="col-lg-3">
													<input value="19" id="group_1_illness19_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢性肾炎</span>
												</label> <label class="col-lg-3"> <input value="20"
													id="group_1_illness20_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢性胆囊炎/胆石症</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="21"
													id="group_1_illness21_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">肺炎</span></label> <label class="col-lg-3"> <input
													value="22" id="group_1_illness22_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">肺结核</span></label> <label class="col-lg-3">
													<input value="23" id="group_1_illness23_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">脂肪肝</span>
												</label> <label class="col-lg-3"> <input value="24"
													id="group_1_illness24_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">肝硬化</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="25"
													id="group_1_illness25_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">丙肝</span></label> <label class="col-lg-3"> <input
													value="26" id="group_1_illness26_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">甲亢</span></label> <label class="col-lg-3">
													<input value="27" id="group_1_illness27_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">甲减</span>
												</label> <label class="col-lg-3"> <input value="28"
													id="group_1_illness28_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">甲状腺结节</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="29"
													id="group_1_illness29_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">甲状腺癌</span></label> <label class="col-lg-3"> <input
													value="30" id="group_1_illness30_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">食管癌</span></label> <label class="col-lg-3">
													<input value="31" id="group_1_illness31_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">肺癌</span>
												</label> <label class="col-lg-3"> <input value="32"
													id="group_1_illness32_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">肝癌</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="33"
													id="group_1_illness33_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">卵巢癌</span></label> <label class="col-lg-3"> <input
													value="34" id="group_1_illness34_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">乳腺癌</span></label> <label class="col-lg-3">
													<input value="35" id="group_1_illness35_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">子宫内膜癌</span>
												</label> <label class="col-lg-3"> <input value="36"
													id="group_1_illness36_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">肝癌</span>
												</label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="37"
													id="group_1_illness37_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">结直肠癌</span></label> <label class="col-lg-3"> <input
													value="38" id="group_1_illness38_checkbox"
													name="group_1_illness_checkbox" type="checkbox" class="">
													<span class="text">宫颈癌</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="39"
													id="group_1_illness39_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢阻肺（慢性支气管炎/肺气肿）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="40"
													id="group_1_illness40_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢性肾病（肾炎/肾病综合性/慢性肾功能不全）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="41"
													id="group_1_illness41_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢阻肺（乳腺增生/结节/腺病/囊肿等）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="42"
													id="group_1_illness42_checkbox"
													name="group_1_illness_checkbox" type="checkbox"> <span
													class="text">慢阻肺（子宫肌瘤/卵巢囊肿/炎症等）</span></label>
											</div>
										</div>
									</div>

									<div>
										<h4 class="block col-lg-12">2.您是否长期服用（连续服用3个月以上，平均每日服用一次以上）下列药物？（若有，请在“□”处选择，否则不用填写）
										</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-4"> <input value="1"
													id="group_1_keepDrugThreeMonth1_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">降压药</span></label> <label class="col-lg-4">
													<input value="2" id="group_1_keepDrugThreeMonth2_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox"
													class=""> <span class="text">降糖药</span>
												</label> <label class="col-lg-4"> <input value="3"
													id="group_1_keepDrugThreeMonth3_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">调脂药（降脂药）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-4"> <input value="4"
													id="group_1_keepDrugThreeMonth4_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">降尿酸药</span></label> <label class="col-lg-4">
													<input value="5" id="group_1_keepDrugThreeMonth5_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox"
													class=""> <span class="text">抗心律失常药</span>
												</label> <label class="col-lg-4"> <input value="6"
													id="group_1_keepDrugThreeMonth6_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">缓解哮喘药物</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-4"> <input value="7"
													id="group_1_keepDrugThreeMonth7_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">镇静剂或安眠药</span></label> <label class="col-lg-4">
													<input value="8" id="group_1_keepDrugThreeMonth8_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox"
													class=""> <span class="text">中草药</span>
												</label> <label class="col-lg-4"> <input value="9"
													id="group_1_keepDrugThreeMonth9_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">激素类药物</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-4"> <input value="10"
													id="group_1_keepDrugThreeMonth10_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">解热镇痛药</span></label> <label class="col-lg-4">
													<input value="11"
													id="group_1_keepDrugThreeMonth11_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox"
													class=""> <span class="text">精神类药物</span>
												</label> <label class="col-lg-4"> <input value="12"
													id="group_1_keepDrugThreeMonth12_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">其它</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-3"> <input value="13"
													id="group_1_keepDrugThreeMonth13_checkbox"
													name="group_1_keepDrugThreeMonth_checkbox" type="checkbox">
													<span class="text">抗血小板类药物（如阿司匹林等）</span></label>
											</div>
										</div>
									</div>

									<div>
										<h4 class="block col-lg-12">3.最近3个月，您是否有以下躯体症状？(多选)</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-6"> <input value="1"
													id="group_1_threeMonthSomatization1_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">头晕、头痛、头胀、头部压近紧箍感</span></label>
												<label class="col-lg-6"> <input value="2"
													id="group_1_threeMonthSomatization2_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox" class=""> <span class="text">胸痛、胸闷、心慌</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-6"> <input value="3"
													id="group_1_threeMonthSomatization3_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">颈肩不适、活动障碍、上下肢麻木</span></label>
												<label class="col-lg-6"> <input value="4"
													id="group_1_threeMonthSomatization4_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox" class=""> <span class="text">吞咽困难、反酸</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-6"> <input value="5"
													id="group_1_threeMonthSomatization5_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">腰椎久坐疼痛酸胀、活动受限、腿脚麻木</span></label>
												<label class="col-lg-6"> <input value="6"
													id="group_1_threeMonthSomatization6_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox" class=""> <span class="text">气紧、气促、呼吸困难</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-6"> <input value="7"
													id="group_1_threeMonthSomatization7_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">小便异常、阴道出血、外阴瘙痒、痛经</span></label>
												<label class="col-lg-6"> <input value="8"
													id="group_1_threeMonthSomatization8_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox" class=""> <span class="text">乳房有包块、疼痛（与月经周期无关）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="9"
													id="group_1_threeMonthSomatization9_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">身体消瘦或体重减轻（3个月内体重减轻超过原体重10%）</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="10"
													id="group_1_threeMonthSomatization10_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">腹痛、腹胀、腹部不适</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="11"
													id="group_1_threeMonthSomatization11_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">大便异常</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="12"
													id="group_1_threeMonthSomatization12_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">浮肿</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="13"
													id="group_1_threeMonthSomatization13_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">关节疼痛，活动僵硬受限</span></label>
											</div>
											<div class="checkbox  form-group">
												<label class="col-lg-12"> <input value="14"
													id="group_1_threeMonthSomatization14_checkbox"
													name="group_1_threeMonthSomatization_checkbox"
													type="checkbox"> <span class="text">其他特殊不适</span></label>
											</div>

										</div>
									</div>
									<div class="col-sm-8  col-xs-offset-4 btn-bottm"
										style="padding-top: 25px">
										<!--<button onclick="back(5)" type="button" class=" btn btn-darkorange col-sm-2  prev-btn">上一步</button>-->
										<button type="button" onclick="next(2)"
											class=" btn btn-active col-sm-2 col-xs-offset-4 next-btn">下一步</button>
									</div>
								</div>
							</form>
						</section>

						<section id="sec2" name="section1">
							<div class="bancgud row">
								<div class="formfont wjdc_top col-lg-12">
									<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.2</span>
									<span class="inform">个人既往史信息</span>
								</div>
								<div>
									<h4 class="block col-lg-12">4.您有头部外伤史吗？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class=" col-lg-2"><input value="1"
												id="group_2_headInjuryHistory1_radio"
												name="group_2_headInjuryHistory_radio" type="radio" class="">
												<span class="text">没有</span></label> <label class="col-lg-2">
												<input value="2" id="group_2_headInjuryHistory2_radio"
												name="group_2_headInjuryHistory_radio" type="radio" class="">
												<span class="text">有过</span>
											</label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">5.您是否被医师诊断患有偏头痛？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input
												id="group_2_migraineHistory1_radio" value="1"
												name="group_2_migraineHistory_radio" type="radio" class="">
												<span class="text">否</span></label> <label class="col-lg-2"><input
												id="group_2_migraineHistory2_radio" value="2"
												name="group_2_migraineHistory_radio" type="radio" class="">
												<span class="text">是</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">6.您是否做过颈动脉B超？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_arteriaBCHistory1_radio"
												name="group_2_arteriaBCHistory_radio" type="radio" class="">
												<span class="text">否</span></label> <label class="col-lg-2">
												<input value="2" id="group_2_arteriaBCHistory2_radio"
												name="group_2_arteriaBCHistory_radio" type="radio" class="">
												<span class="text">是</span>
											</label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">7.您的颈动脉有斑块吗？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_plaqueHistory1_radio"
												name="group_2_plaqueHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input value="2" id="group_2_plaqueHistory2_radio"
												name="group_2_plaqueHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input value="3"
												id="group_2_plaqueHistory3_radio"
												name="group_2_plaqueHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">8.您的颈动脉斑块性质如何？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_plaqueNatureHistory1_radio"
												name="group_2_plaqueNatureHistory_radio" type="radio"
												class=""> <span class="text">软斑 </span></label> <label
												class="col-lg-2"> <input value="2"
												id="group_2_plaqueNatureHistory2_radio"
												name="group_2_plaqueNatureHistory_radio" type="radio"
												class=""> <span class="text">硬斑</span></label> <label
												class="col-lg-2"> <input value="3"
												id="group_2_plaqueNatureHistory3_radio"
												name="group_2_plaqueNatureHistory_radio" type="radio"
												class=""> <span class="text">混合斑</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">9.您的眼底动脉硬化情况如何？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_arteriosclerosisHistory1_radio"
												name="group_2_arteriosclerosisHistory_radio" type="radio"
												class=""> <span class="text">不清楚</span></label> <label
												class="col-lg-2"> <input value="2"
												id="group_2_arteriosclerosisHistory2_radio"
												name="group_2_arteriosclerosisHistory_radio" type="radio"
												type="radio" class=""> <span class="text">无硬化</span></label>
											<label class="col-lg-2"> <input value="3"
												id="group_2_arteriosclerosisHistory3_radio"
												name="group_2_arteriosclerosisHistory_radio" type="radio"
												type="radio" class=""> <span class="text">I度硬化</span></label>
											<label class="col-lg-2"> <input value="4"
												id="group_2_arteriosclerosisHistory4_radio"
												name="group_2_arteriosclerosisHistory_radio" type="radio"
												class=""> <span class="text">II度硬化</span></label> <label
												class="col-lg-2"> <input value="5"
												id="group_2_arteriosclerosisHistory5_radio"
												name="group_2_arteriosclerosisHistory_radio" type="radio"
												class=""> <span class="text">III度硬化</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">10.您的大便情况如何</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_shitHistory1_radio"
												name="group_2_shitHistory_radio" type="radio" class="">
												<span class="text">长期便秘</span></label> <label class="col-lg-2">
												<input value="2" id="group_2_shitHistory2_radio"
												name="group_2_shitHistory_radio" type="radio" class="">
												<span class="text">大便规律，成形</span>
											</label> <label class="col-lg-2"> <input value="3"
												id="group_2_shitHistory3_radio"
												name="group_2_shitHistory_radio" type="radio" class="">
												<span class="text">大便规律，不成形</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">11.您是否有过幽门螺杆菌（Hp)感染的诊断</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_hpHistory1_radio" name="group_2_hpHistory_radio"
												type="radio" class=""> <span class="text">没有</span></label>
											<label class="col-lg-2"> <input value="2"
												id="group_2_hpHistory2_radio" name="group_2_hpHistory_radio"
												type="radio" class=""> <span class="text">有过</span></label>
										</div>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">12.您是否有过累粘膜萎缩的诊断？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"> <input value="1"
												id="group_2_mucosaWSHistory1_radio"
												name="group_2_mucosaWSHistory_radio" type="radio" class="">
												<span class="text">没有</span></label> <label class="col-lg-2">
												<input value="2" id="group_2_mucosaWSHistory2_radio"
												name="group_2_mucosaWSHistory_radio" type="radio" class="">
												<span class="text">有过</span>
											</label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t13"></i>
										13.您是否有过高血压病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t13"
												value="1" id="group_2_hypertensionHistory1_radio"
												name="group_2_hypertensionHistory_radio" type="radio"
												class=""> <span class="text">不清楚 </span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t13"
												value="2" id="group_2_hypertensionHistory2_radio"
												name="group_2_hypertensionHistory_radio" type="radio"
												class=""> <span class="text">无</span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t13"
												value="3" id="group_2_hypertensionHistory3_radio"
												name="group_2_hypertensionHistory_radio" type="radio"
												class=""> <span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t14"></i>
										14.您是否有过脑卒中吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t14"
												value="1" id="group_2_cerebralApoplexyHistory1_radio"
												name="group_2_cerebralApoplexyHistory_radio" type="radio"
												class=""> <span class="text">不清楚 </span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t14"
												value="2" id="group_2_cerebralApoplexyHistory2_radio"
												name="group_2_cerebralApoplexyHistory_radio" type="radio"
												class=""> <span class="text">无</span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t14"
												value="3" id="group_2_cerebralApoplexyHistory3_radio"
												name="group_2_cerebralApoplexyHistory_radio" type="radio"
												class=""> <span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t15"></i>
										15.您是否有过冠心病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t15"
												value="1" id="group_2_chdHistory1_radio"
												name="group_2_chdHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t15" value="2"
												id="group_2_chdHistory2_radio"
												name="group_2_chdHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t15"
												value="3" id="group_2_chdHistory3_radio"
												name="group_2_chdHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t16"></i>
										16.您是否有过心肌梗塞吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t16"
												value="1" id="group_2_MIHistory1_radio"
												name="group_2_MIHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t16" value="2"
												id="group_2_MIHistory2_radio" name="group_2_MIHistory_radio"
												type="radio" class=""> <span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t16"
												value="2" id="group_2_MIHistory3_radio"
												name="group_2_MIHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t17"></i>
										17.您是否有过肺心病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t17"
												value="1" id="group_2_phdHistory1_radio"
												name="group_2_phdHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t17" value="2"
												id="group_2_phdHistory2_radio"
												name="group_2_phdHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t17"
												value="3" id="group_2_phdHistory3_radio"
												name="group_2_phdHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t18"></i>
										18.您是否有过糖尿病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t18"
												value="1" name="group_2_diabetesHistory_radio"
												id="group_2_diabetesHistory1_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t18" value="2"
												name="group_2_diabetesHistory_radio"
												id="group_2_diabetesHistory2_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t18"
												value="3" name="group_2_diabetesHistory_radio"
												id="group_2_diabetesHistory3_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t19"></i>
										19.您是否有过脂肪肝吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t19"
												value="1" id="group_2_fattyLiverHistory1_radio"
												name="group_2_fattyLiverHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t19" value="2"
												id="group_2_fattyLiverHistory2_radio"
												name="group_2_fattyLiverHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t19"
												value="3" id="group_2_fattyLiverHistory3_radio"
												name="group_2_fattyLiverHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t20"></i>
										20.您是否有过胆囊疾病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t20"
												value="1" id="group_2_cholecystIllnessHistory1_radio"
												name="group_2_cholecystIllnessHistory_radio" type="radio"
												class=""> <span class="text">不清楚 </span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t20"
												value="2" id="group_2_cholecystIllnessHistory2_radio"
												name="group_2_cholecystIllnessHistory_radio" type="radio"
												class=""> <span class="text">无</span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t20"
												value="3" id="group_2_cholecystIllnessHistory3_radio"
												name="group_2_cholecystIllnessHistory_radio" type="radio"
												class=""> <span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t21"></i>
										21.您是否有过肾脏疾病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t21"
												value="1" id="group_2_kidneyIllnessHistory1_radio"
												name="group_2_kidneyIllnessHistory_radio" type="radio"
												class=""> <span class="text">不清楚 </span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t21"
												value="2" id="group_2_kidneyIllnessHistory2_radio"
												name="group_2_kidneyIllnessHistory_radio" type="radio"
												class=""> <span class="text">无</span></label> <label
												class="col-lg-2"> <input tab="tab_2" t="t21"
												value="3" id="group_2_kidneyIllnessHistory3_radio"
												name="group_2_kidneyIllnessHistory_radio" type="radio"
												class=""> <span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t22"></i>22.您是否有过结核病吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t22"
												value="1" id="group_2_TBHistory1_radio"
												name="group_2_TBHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t22" value="2"
												id="group_2_TBHistory2_radio" name="group_2_TBHistory_radio"
												type="radio" class=""> <span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t22"
												value="3" id="group_2_TBHistory3_radio"
												name="group_2_TBHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t23"></i>23.您是否有过肝炎吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t23"
												value="1" id="group_2_hepatitisHistory1_radio"
												name="group_2_hepatitisHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t23" value="2"
												id="group_2_hepatitisHistory2_radio"
												name="group_2_hepatitisHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t23"
												value="3" id="group_2_hepatitisHistory3_radio"
												name="group_2_hepatitisHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t24"></i>24.您是否有过肿瘤吗？
									</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input tab="tab_2" t="t24"
												value="1" id="group_2_tumourHistory1_radio"
												name="group_2_tumourHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input tab="tab_2" t="t24" value="2"
												id="group_2_tumourHistory2_radio"
												name="group_2_tumourHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input tab="tab_2" t="t24"
												value="3" id="group_2_tumourHistory3_radio"
												name="group_2_tumourHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">25.您是否有过妇科疾病吗？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_gdHistory1_radio" name="group_2_gdHistory_radio"
												type="radio" class=""> <span class="text">不清楚
											</span></label> <label class="col-lg-2"> <input value="2"
												id="group_2_gdHistory2_radio" name="group_2_gdHistory_radio"
												type="radio" class=""> <span class="text">无</span></label> <label
												class="col-lg-2"> <input value="3"
												id="group_2_gdHistory3_radio" name="group_2_gdHistory_radio"
												type="radio" class=""> <span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">26.您是否有过手术外伤吗？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_OPSHistory1_radio"
												name="group_2_OPSHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<input value="2" id="group_2_OPSHistory2_radio"
												name="group_2_OPSHistory_radio" type="radio" class="">
												<span class="text">无</span>
											</label> <label class="col-lg-2"> <input value="3"
												id="group_2_OPSHistory3_radio"
												name="group_2_OPSHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">27.您是否有过乳腺病手术史吗？</h4>
									<div class="col-lg-12">
										<div class="form-group">
											<label class="col-lg-2"><input value="1"
												id="group_2_mastopathyHistory1_radio"
												name="group_2_mastopathyHistory_radio" type="radio" class="">
												<span class="text">不清楚 </span></label> <label class="col-lg-2">
												<inputvalue ="2" id="group_2_mastopathyHistory2_radio"
													name="group_2_mastopathyHistory_radio" type="radio"
													class=""> <span class="text">无</span>
											</label> <label class="col-lg-2"> <input value="3"
												id="group_2_mastopathyHistory3_radio"
												name="group_2_mastopathyHistory_radio" type="radio" class="">
												<span class="text">有</span></label>
										</div>
									</div>
								</div>


								<div class="col-sm-8  col-xs-offset-3 btn-bottm"
									style="padding-top: 25px">
									<button onclick="back(1)" type="button"
										class=" btn btn-darkorange col-sm-2 prev-btn">上一步</button>
									<button type="button" onclick="next(3)"
										class=" btn btn-active col-sm-2 col-xs-offset-3 next-btn">下一步</button>
								</div>
							</div>
						</section>

						<section name="section" id="sec3">
							<div class="bancgud row">
								<div class="formfont wjdc_top col-lg-12">
									<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.3</span>
									<span class="inform">个人家庭史信息</span>
								</div>


								<div>
									<h4 class="block col-lg-12">28.您的亲属目前或曾经是否被医生诊断过患有下列疾病（若有，请选择，否则不用填写）</h4>
									<table class="table table-striped table-hover table-bordered">
										<tbody>
											<tr>
												<td width="10%"><b>疾病名称</b></td>
												<td width="7%"><b>父亲</b></td>
												<td width="7%"><b>母亲</b></td>
												<td width="7%"><b>兄弟</b></td>
												<td width="7%"><b>姐妹</b></td>
												<td width="25%"><b>疾病名称</b></td>
												<td width="7%"><b>父亲</b></td>
												<td width="7%"><b>母亲</b></td>
												<td width="7%"><b>兄弟</b></td>
												<td width="7%"><b>姐妹</b></td>
											</tr>
											<tr>
												<td width="10%">糖尿病</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" name="group_3_diabetesfamily_checkbox"
														id="group_3_diabetesfamily1_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" name="group_3_diabetesfamily_checkbox"
														id="group_3_diabetesfamily2_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" name="group_3_diabetesfamily_checkbox"
														id="group_3_diabetesfamily3_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" name="group_3_diabetesfamily_checkbox"
														id="group_3_diabetesfamily4_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">慢阴肺（慢性支气管炎/肺气肿）</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_cLungfamily1_checkbox"
														name="group_3_cLungfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_cLungfamily2_checkbox"
														name="group_3_cLungfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_cLungfamily3_checkbox"
														name="group_3_cLungfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_cLungfamily4_checkbox"
														name="group_3_cLungfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">高血压</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_HCHfamily1_checkbox"
														name="group_3_HCHfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_HCHfamily2_checkbox"
														name="group_3_HCHfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_HCHfamily3_checkbox"
														name="group_3_HCHfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_HCHfamily4_checkbox"
														name="group_3_HCHfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">痛风（高尿酸血症）</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_goutfamily1_checkbox"
														name="group_3_goutfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_goutfamily2_checkbox"
														name="group_3_goutfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_goutfamily3_checkbox"
														name="group_3_goutfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_goutfamily4_checkbox"
														name="group_3_goutfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">高脂血症</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_HLPfamily1_checkbox"
														name="group_3_HLPfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_HLPfamily2_checkbox"
														name="group_3_HLPfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_HLPfamily3_checkbox"
														name="group_3_HLPfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_HLPfamily4_checkbox"
														name="group_3_HLPfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">脑卒中（脑中风）</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_strokefamily1_checkbox"
														name="group_3_strokefamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_strokefamily2_checkbox"
														name="group_3_strokefamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_strokefamily3_checkbox"
														name="group_3_strokefamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_strokefamily4_checkbox"
														name="group_3_strokefamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">哮喘</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_asthmafamily1_checkbox"
														name="group_3_asthmafamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_asthmafamily2_checkbox"
														name="group_3_asthmafamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_asthmafamily3_checkbox"
														name="group_3_asthmafamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_asthmafamily4_checkbox"
														name="group_3_asthmafamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">冠心病或心肌梗死</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_MIfamily1_checkbox"
														name="group_3_MIfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_MIfamily2_checkbox"
														name="group_3_MIfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_MIfamily3_checkbox"
														name="group_3_MIfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_MIfamily4_checkbox"
														name="group_3_MIfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">甲状腺癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_thyroidCAfamily1_checkbox"
														name="group_3_thyroidCAfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_thyroidCAfamily2_checkbox"
														name="group_3_thyroidCAfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_thyroidCAfamily3_checkbox"
														name="group_3_thyroidCAfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_thyroidCAfamily4_checkbox"
														name="group_3_thyroidCAfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">结直肠癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_colorectalCancerfamily1_checkbox"
														name="group_3_colorectalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_colorectalCancerfamily2_checkbox"
														name="group_3_colorectalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_colorectalCancerfamily3_checkbox"
														name="group_3_colorectalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_colorectalCancerfamily4_checkbox"
														name="group_3_colorectalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">肺癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_lungCancerfamily1_checkbox"
														name="group_3_lungCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_lungCancerfamily2_checkbox"
														name="group_3_lungCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_lungCancerfamily3_checkbox"
														name="group_3_lungCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_lungCancerfamily4_checkbox"
														name="group_3_lungCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">前列腺癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_prostateCancerfamily1_checkbox"
														name="group_3_prostateCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_prostateCancerfamily2_checkbox"
														name="group_3_prostateCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_prostateCancerfamily3_checkbox"
														name="group_3_prostateCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_prostateCancerfamily4_checkbox"
														name="group_3_prostateCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">食道癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_esophagusCancerfamily1_checkbox"
														name="group_3_esophagusCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_esophagusCancerfamily2_checkbox"
														name="group_3_esophagusCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_esophagusCancerfamily3_checkbox"
														name="group_3_esophagusCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_esophagusCancerfamily4_checkbox"
														name="group_3_esophagusCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">鼻咽癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_nasopharynxCancerfamily1_checkbox"
														name="group_3_nasopharynxCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_nasopharynxCancerfamily2_checkbox"
														name="group_3_nasopharynxCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_nasopharynxCancerfamily3_checkbox"
														name="group_3_nasopharynxCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_nasopharynxCancerfamily4_checkbox"
														name="group_3_nasopharynxCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">宫颈癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_cervicalCancerfamily1_checkbox"
														name="group_3_cervicalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_cervicalCancerfamily2_checkbox"
														name="group_3_cervicalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_cervicalCancerfamily3_checkbox"
														name="group_3_cervicalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_cervicalCancerfamily4_checkbox"
														name="group_3_cervicalCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">乳腺癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_breastCancerfamily1_checkbox"
														name="group_3_breastCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_breastCancerfamily2_checkbox"
														name="group_3_breastCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_breastCancerfamily3_checkbox"
														name="group_3_breastCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_breastCancerfamily4_checkbox"
														name="group_3_breastCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">卵巢癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_ovarianCancerfamily1_checkbox"
														name="group_3_ovarianCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_ovarianCancerfamily2_checkbox"
														name="group_3_ovarianCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_ovarianCancerfamily3_checkbox"
														name="group_3_ovarianCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_ovarianCancerfamily4_checkbox"
														name="group_3_ovarianCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">子宫内膜癌</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_endometrialCancerfamily1_checkbox"
														name="group_3_endometrialCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_endometrialCancerfamily2_checkbox"
														name="group_3_endometrialCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_endometrialCancerfamily3_checkbox"
														name="group_3_endometrialCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_endometrialCancerfamily4_checkbox"
														name="group_3_endometrialCancerfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
											<tr>
												<td width="10%">其他疾病</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_ortherfamily1_checkbox"
														name="group_3_ortherfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_ortherfamily2_checkbox"
														name="group_3_ortherfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_ortherfamily3_checkbox"
														name="group_3_ortherfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_ortherfamily4_checkbox"
														name="group_3_ortherfamily_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="25%">髋部骨折</td>
												<td width="7%"><label> <input type="checkbox"
														value="1" id="group_3_hipFracture1_checkbox"
														name="group_3_hipFracture_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="2" id="group_3_hipFracture2_checkbox"
														name="group_3_hipFracture_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="3" id="group_3_hipFracture3_checkbox"
														name="group_3_hipFracture_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
												<td width="7%"><label> <input type="checkbox"
														value="4" id="group_3_hipFracture4_checkbox"
														name="group_3_hipFracture_checkbox"> <span
														class="text" id="dohovertree"></span>
												</label></td>
											</tr>
										</tbody>
									</table>
								</div>
								<div class="col-sm-8  col-xs-offset-3 btn-bottm"
									style="padding-top: 25px">
									<button type="button" onclick="back(2)"
										class=" btn btn-darkorange col-sm-2 prev-btn">上一步</button>
									<button type="button" onclick="next(4)"
										class=" btn btn-active col-sm-2 col-xs-offset-3 next-btn">下一步</button>
								</div>
							</div>
						</section>
						<section name="section" id="sec4">
							<!-- <form class="form-horizontal form-bordered" role="form"> -->
							<div class="bancgud row">
								<div class="formfont wjdc_top col-lg-12">
									<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.4</span>
									<span class="inform">个人生活信息</span>
								</div>
								<!--<div class="formfont col-lg-12">四  个人生活信息</div>-->
								<h4 class="block col-lg-12">
									<i class="fa fa-exclamation-circle" id="t29"></i> 29.您现在吸烟吗？
								</h4>
								<div class="col-lg-12">
									<div class="checkbox">
										<label class="col-lg-2"> <input tab="tab_4" t="t29"
											id="group_4_smork1_radio" value="1"
											onclick="sendHead('30,31,32,33,34,35,36,37,38')"
											name="group_4_smork_radio" type="radio"
											data-bv-field="form-field-checkbox"> <span
											class="text" checked="">从不吸烟</span>
										</label> <label class="col-lg-3"> <input tab="tab_4" t="t29"
											id="group_4_smork2_radio" value="2"
											onclick="sendHead('30,31,32,33,34,35')"
											name="group_4_smork_radio" type="radio" class=""
											data-bv-field="form-field-checkbox"> <span
											class="text">以前吸，但现在已经戒烟</span>
										</label> <label class="col-lg-2"> <input tab="tab_4" t="t29"
											id="group_4_smork3_radio" value="3" onclick="sendHead('')"
											name="group_4_smork_radio" type="radio" class=""
											data-bv-field="form-field-checkbox"> <span
											class="text">吸烟</span>
										</label>
									</div>
								</div>
								<div id="group30">
									<h4 class="block col-lg-12">
										<div class="">
											30.您开始吸烟的年龄为&nbsp;<span title="" class="tooltip-f"> <input
												type="text" id="group_4_smorkAge_text"
												name="group_4_smorkAge_text"
												class="textbox-text validatebox-text textbox-prompt"
												autocomplete="off" placeholder=""
												style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 50px; text-align: center">
											</span>&nbsp;岁。</span>
										</div>
									</h4>
								</div>
								<div id="group31">
									<h4 class="block col-lg-12">
										<div class="wenjuan-question-tit">
											31.您开始吸烟离现在有&nbsp;<span title="" class="tooltip-f"> <input
												type="text" id="group_4_smorkTime_text"
												name="group_4_smorkTime_text"
												class="textbox-text validatebox-text textbox-prompt"
												autocomplete="off" placeholder=""
												style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 50px; text-align: center">
											</span>&nbsp;年。</span>
										</div>
									</h4>
								</div>
								<div id="group32">
									<h4 class="block col-lg-12">32.您吸烟的频率是</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input
												id="group_4_smorkhz1_radio" value="1"
												name="group_4_smorkhz_radio" type="radio" checked="checked">
												<span class="text" checked="">每天吸</span></label> <label
												class="col-lg-2"> <input id="group_4_smorkhz2_radio"
												value="2" name="group_4_smorkhz_radio" type="radio" class="">
												<span class="text">经常吸</span></label> <label class="col-lg-2">
												<input id="group_4_smorkhz3_radio" value="3"
												name="group_4_smorkhz_radio" type="radio" class="">
												<span class="text">偶尔吸</span>
											</label>
										</div>
									</div>
								</div>
								<div id="group33">
									<h4 class="block col-lg-12">33.当目前为止，您是否已经吸了100支烟？</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input
												id="group_4_smorkOneHundred1_radio" value="1"
												name="group_4_smorkOneHundred_radio" type="radio"
												checked="checked"> <span class="text" checked="">是</span></label>
											<label class="col-lg-2"> <input
												id="group_4_smorkOneHundred2_radio" value="2"
												name="group_4_smorkOneHundred_radio" type="radio" class="">
												<span class="text">否</span></label>
										</div>
									</div>
								</div>
								<div id="group34">
									<h4 class="block col-lg-12">34.下列烟草，您通常吸多少？</h4>
									<div class="col-lg-12">
										<table class="table table-striped table-hover table-bordered"
											id="bodyHtml">
											<thead>
												<tr role="row">
													<th width="10%"><label> <span><b>烟草类型</b></span>
													</label></th>
													<th width="10%"><label> <span><b>吸烟频率（选择一项）</b></span><br>
													</label></th>
													<th width="10%"><label> <span><b>吸入（支）</b></span><br>
													</label></th>
													<th width="10%"><label> <span><b>烟草类型</b></span>
													</label></th>
													<th width="10%"><label> <span><b>吸烟频率（选择一项）</b></span><br>
													</label></th>
													<th width="10%"><label> <span><b>吸入（支）</b></span><br>
													</label></th>
												</tr>
											</thead>
											<tbody>
												<tr>
													<td width="10%"><label>机制卷烟</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_jyan1_radio" value="1"
																name="group_4_jyan_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <input
																id="group_4_jyan2_radio" value="2"
																name="group_4_jyan_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_jyanNum_text"
																	name="group_4_jyanNum_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
													<td width="5%"><label>雪茄</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_cigar1_radio" value="1"
																name="group_4_cigar_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <input
																id="group_4_cigar2_radio" value="2"
																name="group_4_cigar_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_cigarNum_text"
																	name="group_4_cigarNum_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
												</tr>

												<tr>
													<td width="10%"><label>手卷烟</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_selfCigar1_radio" value="1"
																name="group_4_selfCigar_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <input
																id="group_4_selfCigar2_radio" value="2"
																name="group_4_selfCigar_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_selfCigarNum_text"
																	name="group_4_selfCigarNum_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
													<td width="5%"><label>电子烟</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_eCigar1_radio" value="1"
																name="group_4_eCigar_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <inputid
																	="group_4_eCigar2_radio" value="2"
																	name="group_4_eCigar_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_eCigar_text"
																	name="group_4_eCigar_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
												</tr>
												<tr>
													<td width="10%"><label>旱烟/烟斗</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_tobacco1_radio" value="1"
																name="group_4_tobacco_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <input
																id="group_4_tobacco2_radio" value="2"
																name="group_4_tobacco_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_tobacco2_text"
																	name="group_4_tobacco2_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
													<td width="5%"><label>其它</label></td>
													<td width="15%">
														<div class="radio">
															<label class="col-lg-6"> <input
																id="group_4_smorkOther1_radio" value="1"
																name="group_4_smorkOther_radio" type="radio"> <span
																class="text" checked="">每天</span></label> <label
																class="col-lg-6"> <input
																id="group_4_smorkOther2_radio" value="2"
																name="group_4_smorkOther_radio" type="radio" class="">
																<span class="text">每周</span></label>
														</div>
													</td>
													<td width="15%">
														<div class="form-group">
															<div class="col-lg-2"></div>
															<div class="col-lg-8">
																<input type="text" id="group_4_smorkOther_text"
																	name="group_4_smorkOther_text" class="form-control">
															</div>
															<div class="col-lg-2"></div>
														</div>
													</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div id="group35">
									<h4 class="block col-lg-12">
										<div class="">
											35.您平均每天吸&nbsp;<span title="" class="tooltip-f"> <input
												type="text" id="group_4_smorkOneDay_text"
												name="group_4_smorkOneDay_text"
												class="textbox-text validatebox-text textbox-prompt"
												autocomplete="off" placeholder=""
												style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 50px; text-align: center">

											</span>&nbsp;支烟（戒烟者填写成功戒烟前的平均吸烟支数）。</span>
										</div>
								</div>
								<div id="group36">
									<h4 class="block col-lg-12">
										<div class="">
											36.您开始戒烟的年龄为&nbsp;<span title="" class="tooltip-f"> <input
												type="text" id="group_4_smorkQuitAge_text"
												name="group_4_smorkQuitAge_text"
												class="textbox-text validatebox-text textbox-prompt"
												autocomplete="off" placeholder=""
												style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 50px; text-align: center">
											</span>&nbsp;岁。</span>
										</div>
								</div>
								<div id="group37">
									<h4 class="block col-lg-12">37.您是否有过反复戒烟经历？</h4>
									<div class="col-lg-12">
										<div class="checkbox  form-group">
											<label class="col-lg-2"> <input
												id="group_4_smorkOverQuit1_radio" value="1"
												name="group_4_smorkOverQuit_radio" type="radio" class="">
												<span class="text">否</span></label> <label class="col-lg-2">
												<input id="group_4_smorkOverQuit2_radio" value="2"
												name="group_4_smorkOverQuit_radio" type="radio" class="">
												<span class="text">是</span>
											</label>
										</div>
									</div>
								</div>
								<div id="group38">
									<h4 class="block col-lg-12">38.您戒烟的最主要原因是？</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input
												id="group_4_smorkQuitMain1_radio" value="1"
												name="group_4_smorkQuitMain_radio" type="radio"> <span
												class="text">身有疾患</span></label> <label class="col-lg-2"> <input
												id="group_4_smorkQuitMain2_radio" value="2"
												name="group_4_smorkQuitMain_radio" type="radio" class="">
												<span class="text">未来健康考虑</span></label> <label class="col-lg-2">
												<input id="group_4_smorkQuitMain3_radio" value="3"
												name="group_4_smorkQuitMain_radio" type="radio" class="">
												<span class="text">家人反对</span>
											</label> <label class="col-lg-2"> <input
												id="group_4_smorkQuitMain4_radio" value="4"
												name="group_4_smorkQuitMain_radio" type="radio" class="">
												<span class="text">医生建议</span></label> <label class="col-lg-2">
												<input id="group_4_smorkQuitMain5_radio" value="5"
												name="group_4_smorkQuitMain_radio" type="radio" class="">
												<span class="text">其它</span>
											</label>

										</div>
									</div>
								</div>
								<h4 class="block col-lg-12">39.和您一起生活或工作的人中是否有人吸烟？</h4>
								<div class="col-lg-6">
									<div class="radio  form-group">
										<label> <input id="group_4_drink1_radio" value="1"
											name="group_4_drink_radio" type="radio"> <span
											class="text">是</span></label> <label class=""> <input
											id="group_4_drink2_radio" value="2"
											name="group_4_drink_radio" type="radio" class=""> <span
											class="text">否</span>
										</label>
									</div>
								</div>
								<h4 class="block col-lg-12">40.您是否经常吸入吸烟者呼出的烟雾(被动吸烟)超过15分钟/天？</h4>
								<div class="col-lg-10">
									<div class="radio  form-group">
										<label> <input value="1" id="group_4_drinkDay1_radio"
											name="group_4_drinkDay_radio" type="radio"> <span
											class="text">几乎每天</span></label> <label class=""> <input
											value="2" id="group_4_drinkDay2_radio"
											name="group_4_drinkDay_radio" type="radio" class="">
											<span class="text">平均每周4~5天</span></label> <label> <input
											value="3" id="group_4_drinkDay3_radio"
											name="group_4_drinkDay_radio" type="radio"> <span
											class="text">平均每周1~3天</span></label> <label class=""> <input
											value="4" id="group_4_drinkDay4_radio"
											name="group_4_drinkDay_radio" type="radio" class="">
											<span class="text">否</span></label> <label> <input value="5"
											id="group_4_drinkDay5_radio" name="group_4_drinkDay_radio"
											type="radio"> <span class="text">是（继续回答第24题）</span>
										</label>
									</div>
								</div>

								<h4 class="block col-lg-12">
									<i class="fa fa-exclamation-circle" id="t41"></i> 41.您喝过酒吗？
								</h4>
								<div class="col-lg-10">
									<div class="radio  form-group">
										<label> <input onclick="showdrink43()" value="1"
											id="group_4_beforeDrink1_radio" tab="tab_4" t="t41"
											name="group_4_beforeDrink_radio" type="radio"> <span
											class="text">喝过酒</span></label> <label class=""> <input
											onclick="drink43()" value="2" tab="tab_4" t="t41"
											id="group_4_beforeDrink2_radio"
											name="group_4_beforeDrink_radio" type="radio" class="">
											<span class="text">从来不喝（跳到52题）</span></label>
									</div>
								</div>
								<div class="que_end_43">
									<h4 class="block col-lg-12">42.近1个月是否喝酒？</h4>
									<div class="col-lg-10">
										<div class="radio  form-group">
											<label> <input value="1"
												id="group_4_beforeMonthDrink1_radio"
												name="group_4_beforeMonthDrink_radio" type="radio">
												<span class="text">是</span></label> <label class=""> <input
												value="2" id="group_4_beforeMonthDrink2_radio"
												name="group_4_beforeMonthDrink_radio" type="radio" class="">
												<span class="text">否</span></label>
										</div>
									</div>
									<h4 class="block col-lg-12">43.在过去的1年，您一般多长时间喝一次酒？</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value="1"
												id="group_4_beforeYearDrink1_radio"
												name="group_4_beforeYearDrink_radio" type="radio"> <span
												class="text">几乎每天2次</span></label> <label class="col-lg-2">
												<input value="2" id="group_4_beforeYearDrink2_radio"
												name="group_4_beforeYearDrink_radio" type="radio" class="">
												<span class="text">几乎每天1次</span>
											</label> <label class="col-lg-2"> <input value="3"
												id="group_4_beforeYearDrink3_radio"
												name="group_4_beforeYearDrink_radio" type="radio"> <span
												class="text">每周3-4次</span></label> <label class="col-lg-2">
												<input value="4" id="group_4_beforeYearDrink4_radio"
												name="group_4_beforeYearDrink_radio" type="radio" class="">
												<span class="text">每周1-2次</span>
											</label> <label class="col-lg-3"> <input value="5"
												id="group_4_beforeYearDrink5_radio"
												name="group_4_beforeYearDrink_radio" type="radio"> <span
												class="text">每周至少一次（跳至第46题）</span></label> <label class="col-lg-1">
												<input value="6" id="group_4_beforeYearDrink6_radio"
												name="group_4_beforeYearDrink_radio" type="radio" class="">
												<span class="text">否</span>
											</label>
										</div>
									</div>
									<h4 class="block col-lg-12">
										<div class="">
											44.您从&nbsp;<span title="" class="tooltip-f"> <input
												type="text" id="group_4_startDrink_text"
												name="group_4_startDrink_text"
												class="textbox-text validatebox-text textbox-prompt"
												autocomplete="off" placeholder=""
												style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 50px; text-align: center">
											</span>&nbsp;岁开始，每周都饮酒。</span>
										</div>
										<h4 class="block col-lg-12">45.您饮酒时的饮酒种类和次饮酒量是？</h4>
										<div class="col-lg-12">
											<table class="table table-striped table-hover table-bordered"
												id="bodyHtml">
												<thead>
													<tr role="row">
														<th width="5%"><label> <span><b>类型</b></span>
														</label></th>
														<th width="10%"><label> <span><b>通常情况</b></span><br>
																<span style="color: #aaa">（仅选择一种）</span>
														</label></th>
														<th width="10%"><label> <span><b>特殊日子</b></span><br>
																<span style="color: #aaa">（如宴请、聚会、需大量饮酒）</span>
														</label></th>
														<th width="16%"><label> <span><b>最近一次</b></span>
														</label></th>
													</tr>
												</thead>
												<tbody>
													<tr>
														<td width="15%"><label> <span>
																	啤酒（1大瓶=2小瓶） </span>
														</label></td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_startDrink_text"
																	name="group_4_startDrink_text" class="form-control">
															</div> <label style="line-height: 30px">大瓶</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_beerSpecialDrink_text"
																	name="group_4_beerSpecialDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">大瓶</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_beerlastDrink_text"
																	name="group_4_beerlastDrink_text" class="form-control">
															</div> <label style="line-height: 30px">大瓶</label>
														</td>
													</tr>
													<tr>
														<td width="15%"><label> <span class="text">米酒或黄酒</span>
														</label></td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_riceWineDrink_text"
																	name="group_4_riceWineDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text"
																	id="group_4_riceWineSpecialDrink_text"
																	name="group_4_riceWineSpecialDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_riceWinelastDrink_text"
																	name="group_4_riceWinelastDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>

													</tr>
													<tr>
														<td width="15%"><label style="line-height: 30px">葡萄酒</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_grapeDrink_text"
																	name="group_4_grapeDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_grapeSpecialDrink_text"
																	name="group_4_grapeSpecialDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_grapelastDrink_text"
																	name="group_4_grapelastDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
													</tr>
													<tr>
														<td width="5%"><label> <span class="text">白酒（>=50度）</span>
														</label></td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_whiteDrink_text"
																	name="group_4_whiteDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_whiteSpecialDrink_text"
																	name="group_4_whiteSpecialDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="15%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_whitelastDrink_text"
																	name="group_4_whitelastDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>

													</tr>
													<tr>
														<td width="5%"><label> <span class="text">白酒（<50度）</span>
														</label></td>
														<td width="10%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_hwhiteDrink_text"
																	name="group_4_hwhiteDrink_text" class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="10%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_hwhiteSpecialDrink_text"
																	name="group_4_hwhiteSpecialDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>
														<td width="8%">
															<div class="col-lg-2"></div>
															<div class="col-lg-7">
																<input type="text" id="group_4_hwhitelastDrink_text"
																	name="group_4_hwhitelastDrink_text"
																	class="form-control">
															</div> <label style="line-height: 30px">两</label>
														</td>

													</tr>

												</tbody>
											</table>
										</div>
										<h4 class="block col-lg-12">46.通常您的饮酒方式是？</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input
													id="group_4_drinkStyle1_radio" value="1"
													name="group_4_drinkStyle_radio" type="radio"> <span
													class="text">吃饭时饮酒</span></label> <label class="col-lg-2">
													<input id="group_4_drinkStyle2_radio" value="2"
													name="group_4_drinkStyle_radio" type="radio" class="">
													<span class="text">饭间或饭后饮酒</span>
												</label> <label class="col-lg-2"> <input
													id="group_4_drinkStyle3_radio" value="3"
													name="group_4_drinkStyle_radio" type="radio"> <span
													class="text">没有规律</span></label>
											</div>
										</div>
										<h4 class="block col-lg-12">47.您饮酒后是否感觉浑身发热或头晕？</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_4_drinkReaction1_radio"
													name="group_4_drinkReaction_radio" type="radio"> <span
													class="text">是，喝第一口就开始</span></label> <label class="col-lg-2">
													<input value="2" id="group_4_drinkReaction2_radio"
													name="group_4_drinkReaction_radio" type="radio" class="">
													<span class="text">是，喝少量酒后开始</span>
												</label> <label class="col-lg-2"> <input value="3"
													id="group_4_drinkReaction3_radio"
													name="group_4_drinkReaction_radio" type="radio"> <span
													class="text">是，喝大量酒才开始</span></label> <label class="col-lg-2">
													<input value="4" id="group_4_drinkReaction4_radio"
													name="group_4_drinkReaction_radio" type="radio"> <span
													class="text">否</span>
												</label>
											</div>
										</div>
										<h4 class="block col-lg-12">48.近1个月，您在早晨饮酒的频率是：</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_4_drinkMonthMorning1_radio"
													name="group_4_drinkMonthMorning_radio" type="radio">
													<span class="text">从不</span></label> <label cclass="col-lg-2">
													<input value="2" id="group_4_drinkMonthMorning2_radio"
													name="group_4_drinkMonthMorning_radio" type="radio"
													class=""> <span class="text">每周至少1天</span>
												</label> <label class="col-lg-2"> <input value="3"
													id="group_4_drinkMonthMorning3_radio"
													name="group_4_drinkMonthMorning_radio" type="radio">
													<span class="text">每周有几天</span></label> <label class="col-lg-2">
													<input value="4" id="group_4_drinkMonthMorning4_radio"
													name="group_4_drinkMonthMorning_radio" type="radio">
													<span class="text">每天或者几乎每天</span>
												</label>
											</div>
										</div>
										<h4 class="block col-lg-12">49.近1个月，您是否有以下经历：</h4>
										<div class="col-lg-12">
											<div class="radio  ">
												<div class="form-group row">
													<label class="col-lg-4"><span class="text">a.因为饮酒无法工作，或无法做任何事情？</span></label>
													<label class="col-lg-2"> <input value="1"
														id="group_4_drinkForNoWork1_radio"
														name="group_4_drinkForNoWork_radio" type="radio">
														<span class="text">是</span></label> <label class="col-lg-2">
														<input value="2" id="group_4_drinkForNoWork2_radio"
														name="group_4_drinkForNoWork_radio" type="radio">
														<span class="text">否</span>
													</label>
												</div>
												<div class="form-group row">
													<label class="col-lg-4"><span class="text">b.饮酒后感觉沮丧、愤怒而无法控制自己？</span></label>
													<label class="col-lg-2"> <input value="1"
														id="group_4_drinkForFree1_radio"
														name="group_4_drinkForFree_radio" type="radio"> <span
														class="text">是</span></label> <label class="col-lg-2"> <input
														value="2" id="group_4_drinkForFree2_radio"
														name="group_4_drinkForFree_radio" type="radio"> <span
														class="text">否</span></label>
												</div>
												<div class="form-group row">
													<label class="col-lg-4"><span class="text">c.无法停止饮酒？</span></label>
													<label class="col-lg-2"> <input value="1"
														id="group_4_drinkNoStop1_radio"
														name="group_4_drinkNoStop_radio" type="radio"> <span
														class="text">是</span></label> <label class="col-lg-2"><input
														value="2" id="group_4_drinkNoStop2_radio"
														name="group_4_drinkNoStop_radio" type="radio"> <span
														class="text">否</span></label>
												</div>
												<div class='form-group row'>
													<label class="col-lg-4"><span class="text">d.停止饮酒后震颤？</span></label>
													<label class="col-lg-2"> <input alue="1"
														id="group_4_drinkTremble1_radio"
														name="group_4_drinkTremble_radio" type="radio"> <span
														class="text">是</span></label> <label class="col-lg-2"> <input
														value="2" id="group_4_drinkTremble2_radio"
														name="group_4_drinkTremble_radio" type="radio"> <span
														class="text">否</span></label>
												</div>
											</div>
										</div>
										<h4 class="block col-lg-12">50.您经常喝醉吗？</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_4_liquor1_radio" name="group_4_liquor_radio"
													type="radio"> <span class="text">几乎每天1次</span></label> <label
													class="col-lg-2"> <input value="2"
													id="group_4_liquor2_radio" name="group_4_liquor_radio"
													type="radio" class=""> <span class="text">每周1次</span></label>
												<label class="col-lg-2"> <input value="3"
													id="group_4_liquor3_radio" name="group_4_liquor_radio"
													type="radio"> <span class="text">每周有几天</span></label> <label
													class="col-lg-2"> <input value="4"
													id="group_4_liquor4_radio" name="group_4_liquor_radio"
													type="radio"> <span class="text">每天或者几乎每天</span>
												</label>
											</div>
										</div>
										<h4 class="block col-lg-12">51.与几年前比，您的饮酒量的变化？</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_4_capacityUp1_radio"
													name="group_4_capacityUp_radio" type="radio"> <span
													class="text">几乎没有变化</span></label> <label class="col-lg-2">
													<input value="2" id="group_4_capacityUp2_radio"
													name="group_4_capacityUp_radio" type="radio" class="">
													<span class="text">大大增加</span>
												</label> <label class="col-lg-2"> <input value="3"
													id="group_4_capacityUp3_radio"
													name="group_4_capacityUp_radio" type="radio"> <span
													class="text">大大减少</span></label>
											</div>
										</div>
								</div>
								<h4 class="block col-lg-12">52.偶尔熬夜？</h4>
								<div class="col-lg-12">
									<div class="radio  form-group">
										<label class="col-lg-2"> <input value="1"
											id="group_4_occasionallyOil1_radio"
											name="group_4_occasionallyOil_radio" type="radio"> <span
											class="text">一般</span></label> <label class="col-lg-2"> <input
											value="3" id="group_4_occasionallyOil3_radio"
											name="group_4_occasionallyOil_radio" type="radio" class="">
											<span class="text">是</span>
										</label> <label class="col-lg-2"> <input value="2"
											id="group_4_occasionallyOil2_radio"
											name="group_4_occasionallyOil_radio" type="radio"> <span
											class="text">否</span></label>
									</div>
								</div>
								<h4 class="block col-lg-12">53.经常熬夜？</h4>
								<div class="col-lg-12">
									<div class="radio  form-group">
										<label class="col-lg-2"> <input value="1"
											id="group_4_oftenOil1_radio" name="group_4_oftenOil_radio"
											type="radio"> <span class="text">一般</span></label> <label
											class="col-lg-2"> <input value="3"
											id="group_4_oftenOil3_radio" name="group_4_oftenOil_radio"
											type="radio" class=""> <span class="text">是</span></label> <label
											class="col-lg-2"> <input value="2"
											id="group_4_oftenOil2_radio" name="group_4_oftenOil_radio"
											type="radio"> <span class="text">否</span></label>
									</div>
								</div>
								<h4 class="block col-lg-12">
									<i id="t54" class="fa fa-exclamation-circle"></i>54.过去一个月，您的总体睡眠质量如何？
								</h4>
								<div class="col-lg-12">
									<div class="radio  form-group">
										<label class="col-lg-2"> <input value="1" tab="tab_4"
											t="t54" id="group_4_sleepMain1_radio"
											name="group_4_sleepMain_radio" type="radio"> <span
											class="text">非常好</span></label> <label class="col-lg-2"> <input
											value="2" tab="tab_4" t="t54" id="group_4_sleepMain2_radio"
											name="group_4_sleepMain_radio" type="radio" class="">
											<span class="text">尚好</span></label> <label class="col-lg-2">
											<input value="3" tab="tab_4" t="t54"
											id="group_4_sleepMain3_radio" name="group_4_sleepMain_radio"
											type="radio"> <span class="text">不好</span>
										</label> <label class="col-lg-2"> <input value="4" tab="tab_4"
											t="t54" id="group_4_sleepMain4_radio"
											name="group_4_sleepMain_radio" type="radio"> <span
											class="text">非常差</span></label>
									</div>
								</div>
								<h4 class="block col-lg-12">
									55.过去一个月您每天平均的实际睡眠时间有 <select style="padding: 0 12px"
										id="group_4_sleepEven_select" name="group_4_sleepEven_select">
										<option value="1">1</option>
										<option value="2">2</option>
										<option value="3">3</option>
										<option value="4">4</option>
										<option value="5">5</option>
										<option value="6">6</option>
										<option value="7">7</option>
										<option value="8">8</option>
										<option value="9">9</option>
										<option value="10">10</option>
									</select> 小时
								</h4>

								<h4 class="block col-lg-12">56.过去一个月，您是否要服药（包括医生开的处方和自购药物）才能入睡？</h4>
								<div class="col-lg-12">
									<div class="radio  form-group">
										<label class="col-lg-2"> <input value="1"
											id="group_4_sleepMonthByDrug1_radio"
											name="group_4_sleepMonthByDrug_radio" type="radio"> <span
											class="text">不用服用</span></label> <label class="col-lg-2"> <input
											value="2" id="group_4_sleepMonthByDrug2_radio"
											name="group_4_sleepMonthByDrug_radio" type="radio" class="">
											<span class="text">平均每周不足1次</span>
										</label> <label class="col-lg-2"> <input value="3"
											id="group_4_sleepMonthByDrug3_radio"
											name="group_4_sleepMonthByDrug_radio" type="radio"> <span
											class="text">平均每周1或2次</span></label> <label class="col-lg-2">
											<input value="4" id="group_4_sleepMonthByDrug4_radio"
											name="group_4_sleepMonthByDrug_radio" type="radio"> <span
											class="text">平均每周3次或更多</span>
										</label>
									</div>
								</div>
								<h4 class="block col-lg-12">
									<i class="fa fa-exclamation-circle" id="t57"></i>57.过去一个月，您是否有过多梦或易惊醒？
								</h4>
								<div class="col-lg-12">
									<div class="radio  form-group">
										<label class="col-lg-2"> <input value="1" tab="tab_4"
											t="t57" id="group_4_sleepLightly1_radio"
											name="group_4_sleepLightly_radio" type="radio"> <span
											class="text">是</span></label> <label class="col-lg-2"> <input
											value="2" id="group_4_sleepLightly2_radio" tab="tab_4"
											t="t57" name="group_4_sleepLightly_radio" type="radio"
											class=""> <span class="text">否</span></label>
									</div>
								</div>
								<div id="neverDrink">
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t58"></i>58.您目前是否从事以下职业1年或以上？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label> <input value="1" tab="tab_4" t="t58"
												id="group_4_professionYear1_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">金属冶炼</span></label> <label> <input tab="tab_4"
												t="t58" value="2" id="group_4_professionYear2_radio"
												name="group_4_professionYear_radio" type="radio" class="">
												<span class="text">煤矿开采</span></label> <label> <input
												tab="tab_4" t="t58" value="3"
												id="group_4_professionYear3_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">隧道开挖</span></label> <label> <input tab="tab_4"
												t="t58" value="4" id="group_4_professionYear4_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">石化</span></label> <label> <input tab="tab_4"
												t="t58" value="5" id="group_4_professionYear5_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">石棉生产</span>
											</label> <label> <input tab="tab_4" t="t58" value="6"
												id="group_4_professionYear6_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">中餐厨师</span></label> <label> <input tab="tab_4"
												t="t58" value="7" id="group_4_professionYear7_radio"
												name="group_4_professionYear_radio" type="radio"> <span
												class="text">无</span></label>
										</div>
									</div>
								</div>
							</div>

							<div class="col-sm-8  col-xs-offset-3 btn-bottm"
								style="padding-top: 25px">
								<button onclick="back(3)" type="button"
									class=" btn btn-darkorange col-sm-2">上一步</button>
								<button type="button" onclick="next(5)"
									class=" btn btn-active col-sm-2 col-xs-offset-3">下一步</button>
							</div>
							<!-- </div>
					</form> -->
						</section>

						<section id="sec5" name="section1">
							<!-- <form class="form-horizontal form-bordered" role="form"> -->
							<div class="bancgud row">
								<div class="formfont wjdc_top col-lg-12">
									<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.5</span>
									<span class="inform">个人膳食信息</span>
								</div>
								<!--<div class="formfont col-lg-12">三 个人膳食信息</div>-->
								<h4 class="block col-lg-12">
									<i id="t59" class="fa fa-exclamation-circle"></i>59.您过去一周内所吃的食物
								</h4>
								<div class="wenjuan-food">
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/nice.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">大米、面粉类、杂粮类</h2>
											[ 1碗米饭≈2两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="cr_w_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	type="radio" id="group_5_foodWeek1_radio" value="1"
																	type="radio" tab="tab_5" t="t59"
																	name="group_5_foodWeek_radio" data-bv-field="d"><span
																	class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	type="radio" tab="tab_5" t="t59"
																	id="group_5_foodWeek2_radio" value="2"
																	name="group_5_foodWeek_radio" data-bv-field="d"><span
																	class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	type="radio" tab="tab_5" t="t59"
																	name="group_5_foodWeek_radio"
																	id="group_5_foodWeek3_radio" value="3"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_foodWeek4_radio"
																	value="4" type="radio" name="group_5_foodWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="cr_d_i">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_foodDay1_radio"
																	value="1" type="radio" name="group_5_foodDay_radio"
																	data-bv-field="d"><span class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_foodDay2_radio"
																	value="2" type="radio" name="group_5_foodDay_radio"
																	data-bv-field="d"><span class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_foodDay3_radio"
																	value="3" type="radio" name="group_5_foodDay_radio"
																	data-bv-field="d"><span class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_foodDay4_radio"
																	value="4" type="radio" name="group_5_foodDay_radio"
																	data-bv-field="d"><span class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/meat.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">肉类（猪，牛，羊，禽）</h2>
											[ 1副扑克牌大小≈2两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="meat_w_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetWeek1_radio" value="1"
																	name="group_5_meetWeek_radio" data-bv-field="d"><span
																	class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetWeek2_radio" value="2"
																	name="group_5_meetWeek_radio" data-bv-field="d"><span
																	class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetWeek3_radio" value="3"
																	name="group_5_meetWeek_radio" data-bv-field="d"><span
																	class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetWeek4_radio" value="4"
																	name="group_5_meetWeek_radio" data-bv-field="d"><span
																	class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="meat_d_i">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetDay1_radio" value="1"
																	name="group_5_meetDay_radio" data-bv-field="d"><span
																	class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetDay2_radio" value="2"
																	name="group_5_meetDay_radio" data-bv-field="d"><span
																	class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetDay3_radio" value="3"
																	name="group_5_meetDay_radio" data-bv-field="d"><span
																	class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_meetDay4_radio" value="4"
																	name="group_5_meetDay_radio" data-bv-field="d"><span
																	class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/fash.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">鱼类或其他水产品：虾、蟹</h2>
											[ 1副扑克牌大小≈2两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="fish_w_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apWeek1_radio" value="1"
																	name="group_5_apWeek_radio" data-bv-field="d"><span
																	class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apWeek2_radio" value="2"
																	name="group_5_apWeek_radio" data-bv-field="d"><span
																	class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apWeek3_radio" value="3"
																	name="group_5_apWeek_radio" data-bv-field="d"><span
																	class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apWeek4_radio" value="4"
																	name="group_5_apWeek_radio" data-bv-field="d"><span
																	class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="fish_d_i">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apDay1_radio" value="1"
																	name="group_5_apDay_radio" data-bv-field="d"><span
																	class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apDay2_radio" value="2"
																	name="group_5_apDay_radio" data-bv-field="d"><span
																	class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apDay3_radio" value="3"
																	name="group_5_apDay_radio" data-bv-field="d"><span
																	class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_apDay4_radio" value="4"
																	name="group_5_apDay_radio" data-bv-field="d"><span
																	class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/egg.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">蛋类及其制品</h2>
											[ 1个鸡蛋≈1两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="egg_w_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggWeek1_radio" value="1"
																	name="group_5_eggWeek_radio" data-bv-field="d"><span
																	class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggWeek2_radio" value="2"
																	name="group_5_eggWeek_radio" data-bv-field="d"><span
																	class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggWeek3_radio" value="3"
																	name="group_5_eggWeek_radio" data-bv-field="d"><span
																	class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggWeek4_radio" value="4"
																	name="group_5_eggWeek_radio" data-bv-field="d"><span
																	class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="egg_d_i">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggDay1_radio" value="1"
																	name="group_5_eggDay_radio" data-bv-field="d"><span
																	class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggDay2_radio" value="2"
																	name="group_5_eggDay_radio" data-bv-field="d"><span
																	class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggDay3_radio" value="3"
																	name="group_5_eggDay_radio" data-bv-field="d"><span
																	class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" type="radio"
																	id="group_5_eggDay4_radio" value="4"
																	name="group_5_eggDay_radio" data-bv-field="d"><span
																	class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/milk.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">牛奶及奶制品</h2>
											[ 1袋240毫升(mL)奶≈1杯 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="milk_w_i" class="">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	type="radio" id="group_5_milkWeek1_radio" value="1"
																	tab="tab_5" t="t59" name="group_5_milkWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_milkWeek2_radio"
																	value="2" type="radio" name="group_5_milkWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_milkWeek3_radio"
																	value="3" type="radio" name="group_5_milkWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" id="group_5_milkWeek4_radio"
																	value="4" type="radio" name="group_5_milkWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day niunai">
												<em id="milk_d_i" class="">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="1"
																	id="group_5_milkday1_radio" type="radio"
																	name="group_5_milkday_radio" data-bv-field="d"><span
																	class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="2"
																	id="group_5_milkday2_radio" type="radio"
																	name="group_5_milkday_radio" data-bv-field="d"><span
																	class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="3"
																	id="group_5_milkday3_radio" type="radio"
																	name="group_5_milkday_radio" data-bv-field="d"><span
																	class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="4"
																	id="group_5_milkday4_radio" type="radio"
																	name="group_5_milkday_radio" data-bv-field="d"><span
																	class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/bean.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">豆类及豆制品</h2>
											[ 1副扑克牌大小≈2两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="bean_w_i" class="">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="1"
																	id="group_5_beanWeek1_radio" type="radio"
																	name="group_5_beanWeek_radio" data-bv-field="d"><span
																	class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="2"
																	id="group_5_beanWeek2_radio" type="radio"
																	name="group_5_beanWeek_radio" data-bv-field="d"><span
																	class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="3"
																	id="group_5_beanWeek3_radio" type="radio"
																	name="group_5_beanWeek_radio" data-bv-field="d"><span
																	class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	tab="tab_5" t="t59" value="4"
																	id="group_5_beanWeek4_radio" type="radio"
																	name="group_5_beanWeek_radio" data-bv-field="d"><span
																	class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="bean_d_i" class="">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_beanday1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_beanday_radio"
																	data-bv-field="d"><span class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_beanday2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_beanday_radio"
																	data-bv-field="d"><span class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_beanday3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_beanday_radio"
																	data-bv-field="d"><span class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_beanday4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_beanday_radio"
																	data-bv-field="d"><span class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="${ctx }/dep/img/vegetables.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">新鲜蔬菜</h2>
											[ 1碗炒熟的青菜≈6两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="vegetable_w_i" class="">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_truckWeek1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_truckWeek2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_truckWeek3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_truckWeek4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="vegetable_d_i" class="">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_truckday1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckday_radio"
																	data-bv-field="d"><span class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_truckday2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckday_radio"
																	data-bv-field="d"><span class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_truckday3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckday_radio"
																	data-bv-field="d"><span class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_truckday4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_truckday_radio"
																	data-bv-field="d"><span class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic">
											<img src="../dep/img/fruits.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">新鲜水果</h2>
											[ 1个苹果≈4两 ]
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week">
												<em id="ffru_w_i" class="">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_fruitWeek1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_fruitWeek2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_fruitWeek3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_fruitWeek4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
											<div class="d-food-rate-show d-food-day">
												<em id="ffru_d_i" class="">每天</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_fruitday1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitday_radio"
																	data-bv-field="d"><span class="text">8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_fruitday2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitday_radio"
																	data-bv-field="d"><span class="text">5-8两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_fruitday3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitday_radio"
																	data-bv-field="d"><span class="text">2-4两</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_fruitday4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fruitday_radio"
																	data-bv-field="d"><span class="text">≤1两</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic" style="margin: 11px 0 12px 0;">
											<img src="../dep/img/dessert.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">甜食（甜点、糖果等）</h2>
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week"
												style="border: none">
												<em id="sweet_food_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_sweetWeek1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_sweetWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_sweetWeek2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_sweetWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_sweetWeek3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_sweetWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_sweetWeek4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_sweetWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic" style="margin: 11px 0 12px 0;">
											<img src="${ctx }/dep/img/fried.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">油炸食品</h2>
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week"
												style="border: none">
												<em id="fried_food_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_fryWeek1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fryWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_fryWeek2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fryWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_fryWeek3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fryWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_fryWeek4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_fryWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div class="wenjuan-food-cell">
										<div class="wenjuan-food-pic" style="margin: 11px 0 12px 0;">
											<img src="../dep/img/pickle.jpg">
										</div>
										<div class="wenjuan-food-name">
											<h2 class="ellipsis">腌、熏类食物</h2>
										</div>
										<div class="wenjuan-food-select">
											<div class="d-food-rate-show d-food-week"
												style="border: none">
												<em id="smoked_food_i">每周</em>
												<table>
													<tbody>
														<tr>
															<td width="150px"><label class="labletab"><input
																	value="1" id="group_5_kindWeek1_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_kindWeek_radio"
																	data-bv-field="d"><span class="text">5-7天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="2" id="group_5_kindWeek2_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_kindWeek_radio"
																	data-bv-field="d"><span class="text">3-4天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="3" id="group_5_kindWeek3_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_kindWeek_radio"
																	data-bv-field="d"><span class="text">1-2天</span></label></td>
															<td width="150px"><label class="labletab"><input
																	value="4" id="group_5_kindWeek4_radio" tab="tab_5"
																	t="t59" type="radio" name="group_5_kindWeek_radio"
																	data-bv-field="d"><span class="text">1天或不吃</span></label></td>
														</tr>
													</tbody>
												</table>
											</div>
										</div>
									</div>
									<div>
										<h4 class="block col-lg-12">
											<i id="t60" class="fa fa-exclamation-circle"></i>60.您一日三餐按时进餐吗？
										</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_5_ehma1_radio" tab="tab_5" t="t60"
													name="group_5_ehma_radio" type="radio" class=""> <span
													class="text">不按时</span></label> <label class="col-lg-2"> <input
													value="2" id="group_5_ehma2_radio" tab="tab_5" t="t60"
													name="group_5_ehma_radio" type="radio" class=""> <span
													class="text">基本按时</span></label> <label class="col-lg-2"> <input
													value="3" id="group_5_ehma3_radio" tab="tab_5" t="t60"
													name="group_5_ehma_radio" type="radio" class=""> <span
													class="text">按时</span></label>
											</div>
										</div>
									</div>
									<div>
										<h4 class="block col-lg-12">
											<i id="t61" class="fa fa-exclamation-circle"></i>61.您的饮食习惯属于以下那种类型？
										</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-2"> <input value="1"
													id="group_5_dh1_radio" tab="tab_5" t="t61"
													name="group_5_dh_radio" type="radio" class=""> <span
													class="text">素食为主</span></label> <label class="col-lg-2"> <input
													value="2" id="group_5_dh2_radio" tab="tab_5" t="t61"
													name="group_5_dh_radio" type="radio" class=""> <span
													class="text">荤素均衡</span></label> <label class="col-lg-2"> <input
													value="3" id="group_5_dh3_radio" tab="tab_5" t="t61"
													name="group_5_dh_radio" type="radio" class=""> <span
													class="text">荤食为主</span></label>
											</div>
										</div>
									</div>
									<div>
										<h4 class="block col-lg-12">
											<i id="t62" class="fa fa-exclamation-circle"></i>62.您每天喝水量大约为？（一杯水为500ml）
										</h4>
										<div class="col-lg-12">
											<div class="checkbox  form-group">
												<label class="col-lg-2"> <input tab="tab_5" t="t62"
													value="1" id="group_5_wya1_radio" name="group_5_wya_radio"
													type="radio" class=""> <span class="text"><1杯</span></label>
												<label class="col-lg-2"> <input tab="tab_5" t="t62"
													value="2" id="group_5_wya2_radio" name="group_5_wya_radio"
													type="radio" class=""> <span class="text">2杯</span></label>
												<label class="col-lg-2"> <input tab="tab_5" t="t62"
													value="3" id="group_5_wya3_radio" name="group_5_wya_radio"
													type="radio" class=""> <span class="text">3杯</span></label>
												<label class="col-lg-2"> <input tab="tab_5" t="t62"
													value="4" id="group_5_wya4_radio" name="group_5_wya_radio"
													type="radio" class=""> <span class="text">4杯</span></label>
											</div>
										</div>
									</div>
								</div>
								<div class="col-sm-8  col-xs-offset-3 btn-bottm"
									style="padding-top: 25px">
									<button type="button" onclick="back(4)"
										class=" btn btn-darkorange col-sm-2  prev-btn">上一步</button>
									<button type="button" onclick="next(6)"
										class=" btn btn-active col-sm-2 col-xs-offset-3 next-btn">下一步</button>
								</div>
							</div>
							<!-- </form> -->
						</section>

						<section name="section1" id="sec6">
							<div class="bancgud row">
								<div class="formfont wjdc_top col-lg-12">
									<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.6</span>
									<span class="inform">个人运动信息</span>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t63"></i>63.在您的工作、农活及家务活动中，有没有高强度活动，并且活动时间持续10分钟以上？（运重物、挖掘等需要付出较大体力，或引起呼吸、心跳显著增加的活动）
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t63"
												value="1" id="group_6_activityTen1_radio" onclick="es('1')"
												name="group_6_activityTen_radio" type="radio"> <span
												class="text">有</span></label> <label class="col-lg-2"> <input
												tab="tab_6" t="t63" value="2"
												id="group_6_activityTen2_radio"
												onclick="es('64,65,66,67,68')"
												name="group_6_activityTen_radio" type="radio" class="">
												<span class="text">没有（跳到第69题）</span></label>
										</div>
									</div>
								</div>
								<div id="part64">
									<h4 class="block col-lg-12">64.在您的工作、农活及家务活动中，通常一周内您进行高强度活动的情况是？</h4>
									<div class="col-lg-12 ">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody class="form-group">
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_hactivityTen_select"
														name="group_6_hactivityTen_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_hactivityHour_text"
														name="group_6_hactivityHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_hactivityMinute_text"
														name="group_6_hactivityMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div id="part65">
									<h4 class="block col-lg-12">65.其中进行高强度家务活动有几天？每天累计有多长时间？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_houseWorkWeekHour_text"
														name="group_6_houseWorkWeekHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_houseWorkWeekMinute_select"
														name="group_6_houseWorkWeekMinute_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div id="part66">
									<h4 class="block col-lg-12">66.在您的工作、农活及家务活动中，有没有中等强度活动，并且活动时间持续10分钟以上？</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value
													="1" name="group_6_mHouseWorkTenHour_radio"
													id="group_6_mHouseWorkTenHour1_radio" type="radio">
												<span class="text">有</span></label> <label class="col-lg-2">
												<input value="2" name="group_6_mHouseWorkTenHour_radio"
												type="radio" id="group_6_mHouseWorkTenHour2_radio"
												type="radio" class=""> <span class="text">没有</span>
											</label>
										</div>
									</div>
								</div>
								<div id="part67">
									<h4 class="block col-lg-12">67.在您的工作、农活及家务活动中，通常一周内您进行中等强度活动的情况是？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_mHouseWorkCase_select"
														name="group_6_mHouseWorkCase_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_mHouseWorkCaseHour_text"
														name="group_6_mHouseWorkCaseHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_mHouseWorkMinute_text"
														name="group_6_mHouseWorkMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div id="part68">
									<h4 class="block col-lg-12">68.其中进行中等强度家务活动有几天？每天累计有多长时间？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_mHouseWorkSomeDay_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_mHouseWorkSomeDayHour_text"
														name="group_6_mHouseWorkSomeDayHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_mHouseWorkSomeDayMinute_text"
														name="group_6_mHouseWorkSomeDayMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i id="t69" class="fa fa-exclamation-circle"></i>69.您在外出时，有没有步行或骑自行车(至少持续10分钟)的情况？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t69"
												value="1" onclick="ea('1')" id="group_6_outByBike1_radio"
												name="group_6_outByBike_radio" type="radio" class="">
												<span class="text">有</span></label> <label class="col-lg-2">
												<input id="group_6_outByBike2_radio" value="2" tab="tab_6"
												t="t69" onclick="ea('70')"
												name="group_6_outByBike_radio" type="radio"> <span
												class="text">没有</span>
											</label>
										</div>
									</div>
								</div>
								<div id="ea70">
									<h4 class="block col-lg-12">70.通常一周内，您外出时步行或骑自行车(至少持续10分钟)的情况是？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_outByBikeTen_select"
														name="group_6_outByBikeTen_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_outByBikeHour_text"
														name="group_6_outByBikeHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_outByBikeMiunte_text"
														name="group_6_outByBikeMiunte_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i id="t71" class="fa fa-exclamation-circle"></i>71.您是否进行高强度锻炼或娱乐活动（如长跑、游泳、踢足球等）？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t71"
												id="group_6_hPhysical1_radio" value="1" onclick="eb('1')"
												name="group_6_hPhysical_radio" type="radio"> <span
												class="text">有</span></label> <label class="col-lg-2"> <input
												tab="tab_6" t="t71" id="group_6_hPhysical2_radio" value="2"
												onclick="eb('58,59')" name="group_6_hPhysical_radio"
												type="radio" class=""> <span class="text">没有</span></label>
										</div>
									</div>

								</div>
								<div id="eb59">
									<h4 class="block col-lg-12">72.通常一周内，您进行上述高强度的锻炼或娱乐活动是？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_hPhysicalWeek_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_hPhysicalWeekHour_text"
														name="group_6_hPhysicalWeekHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_hPhysicalWeekMinute_text"
														name="group_6_hPhysicalWeekMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div id="eb60">
									<h4 class="block col-lg-12">
										<i id="t73" class="fa fa-exclamation-circle"></i>73.您是否进行持续至少10分钟，引起呼吸、心跳轻度增加的中等强度锻炼或娱乐活动吗？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t73"
												value="1" id="group_6_mPhysical1_radio" onclick="ec('1')"
												name="group_6_mPhysical_radio" type="radio"> <span
												class="text">有</span></label> <label class="col-lg-2"> <input
												tab="tab_6" t="t73" value="2" id="group_6_mPhysical2_radio"
												onclick="ec('74')" name="group_6_mPhysical_radio"
												type="radio" class=""> <span class="text">没有</span></label>
										</div>
									</div>
								</div>
								<div id="ec74">
									<h4 class="block col-lg-12">74.通常一周内，您进行上述中等强度的锻炼或娱乐活动是？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="180" title="" class="tooltip-f">每周&nbsp; <select
														autocomplete="off" placeholder=""
														id="group_6_mPhysicalWeek_select"
														name="group_6_mPhysicalWeek_select"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">
															<option value="1">1</option>
															<option value="2">2</option>
															<option value="3">3</option>
															<option value="4">4</option>
															<option value="5">5</option>
															<option value="6">6</option>
															<option value="7">7</option>
													</select> </span>&nbsp;天
													</td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_mPhysicalWeekHour_text"
														name="group_6_mPhysicalWeekHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_mPhysicalWeekMinute_text"
														name="group_6_mPhysicalWeekMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">75.通常一天内，您累计有多少时间坐着、靠着或躺着？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_sittingHour_text"
														name="group_6_sittingHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_sittingMinute_text"
														name="group_6_sittingMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">76.您在业余时间里，平均每天看电视的时间为多少？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_leisureHour_text"
														name="group_6_leisureHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_leisureMinute_text"
														name="group_6_leisureMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">77.您在业余时间里，平均每天使用电脑的时间为多少？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_leisureForPCHour_text"
														name="group_6_leisureForPCHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_leisureForPCMinute_text"
														name="group_6_leisureForPCMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">78.您在业余时间里，平均每天使用手机的时间为多少？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_leisureForPhoneHour_text"
														name="group_6_leisureForPhoneHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_leisureForPhoneMinute_text"
														name="group_6_leisureForPhoneMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>

								<div>
									<h4 class="block col-lg-12">79.您在业余时间里，平均每天用于阅读（纸质读物）的时间为多少？</h4>
									<div class="col-lg-12">
										<table width="100%" cellpadding="0" cellspacing="0">
											<tbody>
												<tr>
													<td width="15"></td>
													<td width="360" title="" class="tooltip-f">每天&nbsp; <input
														type="text" autocomplete="off"
														id="group_6_leisureForReadHour_text"
														name="group_6_leisureForReadHour_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;小时
														<input type="text" autocomplete="off"
														id="group_6_leisureForReadMinute_text"
														name="group_6_leisureForReadMinute_text"
														style="margin-left: 0px; margin-right: 0px; padding-top: 2px; padding-bottom: 2px; width: 80px;">&nbsp;分钟
													</td>
													<td>&nbsp;</td>
													<td>&nbsp;</td>
												</tr>
											</tbody>
										</table>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i id="t80" class="fa fa-exclamation-circle"></i>80.近年来，您平均每周进行专门的体育锻炼多少次？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t80"
												name="group_6_physicalYear_radio"
												id="group_6_physicalYear1_radio" value="1" type="radio">
												<span class="text">3次或以上</span></label> <label class="col-lg-2">
												<input tab="tab_6" t="t80" name="group_6_physicalYear_radio"
												type="radio" id="group_6_physicalYear2_radio" value="2"
												type="radio" class=""> <span class="text">1-2次</span>
											</label> <label class="col-lg-2"> <input tab="tab_6" t="t80"
												name="group_6_physicalYear_radio" type="radio"
												id="group_6_physicalYear3_radio" value="3" type="radio"
												class=""> <span class="text"><1次</span></label>

										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i id="t81" class="fa fa-exclamation-circle"></i>81.您平均每次持续锻炼的时间是多少分钟？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t81"
												name="group_6_keepPhysical_radio"
												id="group_6_keepPhysical1_radio" value="1" type="radio">
												<span class="text">>60分钟</span></label> <label class="col-lg-2">
												<input tab="tab_6" t="t81" name="group_6_keepPhysical_radio"
												id="group_6_keepPhysical2_radio" value="2" type="radio"
												class=""> <span class="text">30-60分钟 </span>
											</label> <label class="col-lg-2"> <input tab="tab_6" t="t81"
												name="group_6_keepPhysical_radio"
												id="group_6_keepPhysical3_radio" value="3" type="radio"
												class=""> <span class="text">30-60分钟 </span></label>

										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">
										<i id="t82" class="fa fa-exclamation-circle"></i>82.您锻炼时是否出汗？
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input tab="tab_6" t="t82"
												value="1" name="group_6_physicalSweat_radio"
												id="group_6_physicalSweat1_radio" type="radio"> <span
												class="text">是</span></label> <label class="col-lg-2"> <input
												tab="tab_6" t="t82" value="2"
												name="group_6_physicalSweat_radio"
												id="group_6_physicalSweat2_radio" type="radio" class="">
												<span class="text">否</span></label>
										</div>
									</div>
								</div>
								<div>
									<h4 class="block col-lg-12">83.您常用的体育锻炼方式是什么？(多选题)</h4>
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												<span class="text">游泳</span>
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												<span class="text">球类</span>
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												<span class="text">室内健身</span></label> <label class="col-lg-2">
												<input value="6" id="group_6_exercisingWay6_checkbox"
												name="group_6_exercisingWay_checkbox" type="checkbox">
												<span class="text">其它</span>
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